宋淦 李珉

【摘要】 目的：探究胸腹腔镜联合手术切除食管癌的手术效果及安全性。方法：选取笔者所在医院2013年6月-2016年12月收治的食管癌患者122例为研究对象，采用随机数字表法将其分为对照组和研究组，每组61例，对照组患者行食管癌根治术治疗，研究组患者接受胸腹腔镜联合管癌根治术治疗，比较两组患者临床治疗效果及术后并发症发生情况。结果：研究组患者的术中出血量及胸腔引流量明显少于对照组，术后拔管时间及住院时间均明显短于对照组，比较差异均有统计学意义（P<0.05）；研究组术后FEV1、FEV1/FVC及PaO2水平明显高于对照组，比较差异均有统计学意义（P<0.05）；研究组的并发症总发生率明显低于对照组，比较差异有统计学意义（字2=4.08，P<0.05）。结论：胸腹腔镜联合手术治疗食管癌具有创伤小及住院时间短等优势，可促进患者术后病情恢复，同时可减轻肺功能损伤程度，且治疗安全性较高，值得临床推广。

【关键词】 胸腹腔镜； 食管癌； 手术效果； 安全性

doi：10.14033/j.cnki.cfmr.2018.7.006 文献标识码 A 文章编号 1674-6805（2018）07-0013-03

【Abstract】 Objective：To explore the surgical effect and safety of thoracoscopy and laparoscopy combined with surgical resection for esophageal cancer.Method：From June 2014 to December 2016，a total of 122 patients with esophageal cancer admitted in the authors hospital were selected and randomly divided into control group and study group，61 cases in each group.The control group was treated with radical resection of esophageal cancer，the study group received thoracoscopy and laparoscopy combined with radical resection of esophageal cancer.The clinical efficacy and postoperative complications were compared between the two groups.Result：The intraoperative blood loss and chest drainage volume in the study group were significantly less than those in the control group，and the time of extubation and hospitalization were significantly shorter than that in the control group，with significant differences（P<0.05）.The level of FEV1，FEV1/FVC and PaO2 in the study group was significantly higher than that in the control group，and the difference was statistically significant（P<0.05）.The total incidence of complications in the study group was significantly lower than that in the control group，the difference was statistically significant（字2=4.08，P<0.05）.Conclusion：Thoracoscopy and laparoscopy combined with radical resection of esophageal cancer with small trauma and short hospital stay and other advantages，can promote postoperative recovery of patients after surgery，while reducing the degree of lung injury，and the treatment of high safety，worthy of clinical promotion.

【Key words】 Thoracoscopy and laparoscopy； Esophageal cancer； Surgical effect； Safety

First-authors address：Macheng City Peoples Hospital，Macheng 438300，China

食管癌是指多發生于食管中段的食管黏膜上皮或食管腺上皮的恶性肿瘤，主要与环境及饮食生活习惯有关，如食用含有亚硝胺类的食物及长期食用热食热饮等[1]。食管癌的早期症状多不明显，患者易忽视，导致就诊时已发展为中晚期，患者出现吞咽困难及癌肿转移等症状[2]。胸腹腔镜及食管癌根治术是目前常用的两种治疗方案，均具有不同优劣势。食管癌根治术主要是指切除肿瘤及其侵犯组织等，但其创伤大且易诱发并发症，影响患者病情恢复[3]。随着我国腔镜技术的发展，胸腹腔镜已成为诊治食管癌的首选治疗方案，其凭借创伤小及对肺功能影响小等优势，已逐渐广泛应用于临床。研究证实，胸腹腔镜联合手术治疗食管癌可取得一定的疗效，但其手术效果及安全性仍存在争议，且目前相关内容文献报道较少，因此笔者就胸腹腔镜联合手术切除食管癌的手术效果及安全性展开报道[4]，旨在为临床提供指导。……